The hypothesis that root rot caused by Pythium irregulare reduces the water use efficiency of wheat was tested in a system which simulated field conditions with late season water stress. Inoculation with Pythium significantly reduced transpiration during vegetative growth, so that plants entered post-anthesis drought with more available water. Although weekly transpiration rates were higher in inoculated plants than controls during the later stages of drought, infected plants were unable to make use of all of the extra water. There were no significant effects of inoculation on shoot biomass or grain yield, while total transpiration was reduced by 14%. Infected plants therefore had significantly higher integrated water use efficiency (grain yield relative to transpiration) than controls. Infected plants were significantly more stressed than controls during the drought, despite higher soil moisture, and showed reduced ability to use stomatal conductance to regulate leaf water potential. Pythium infection caused adverse changes to plant water use and water relations, but these did not translate into reductions in growth or yield. This, and the unexpected increase in water use efficiency, highlights the need to consider interactions with other environmental stresses when making assumptions about the effects of root diseases on crop productivity.